1. Previously on
The Good Doctor…
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2. The aneurysm caused his back pain.
Dr. Wolke missed it.
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3. I screwed up.
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4. - Compressions.
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5. - Dr. Wolke.
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6. He's dead.
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7. Take as much time as you need.
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8. The virus has damaged
your mother's lungs.
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9. We're doing everything we can to help her.
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10. - 120 joules.
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11. I've got hydroxychloroquine, ribavirin…
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12. I'm twice the size of SJ General.
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13. I should have twice the amount of tests.
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14. I'm a doctor. What happened?
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15. I don't know. He was running. I honked.
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16. All of a sudden,
he was in front of my car.
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17. Pedestrian versus car, GCS five at scene.
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18. Rigid abdomen with active bleeding.
Flail chest with pneumo.
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19. He needs an ex lap. Now.
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20. We've got a massive hemoperitoneum.
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21. I need two large suctions
and lap pads in all four quadrants.
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22. There's a grade-three liver laceration
in right lateral segments.
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23. Liver stitch, number 1 chromic
on a blunt needle and a combat gauze.
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24. What were you doing
on your bike at that hour?
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25. Heading into work.
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26. Trying to prep for my budget meeting
with Glassman.
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27. Mobilize the liver to check
for any associated diaphragm injury.
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28. It's the other side of town.
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29. I was taking the scenic route.
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30. BP's dropping.
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31. He's got another bleed.
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32. Add more lap pads and run the bowel.
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33. There's a perforation
near the terminal ileum.
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34. Ah. Something tore
through the intestinal wall.
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35. It's shrapnel.
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36. From the accident?
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37. The coat's eroded.
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38. It looks like it's been in there a while.
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39. It must have gotten dislodged
in the accident.
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40. How does Asher seem to you?
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41. He seems fine.
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42. Too fine for someone
who's just lost their first patient.
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43. I don't have time to worry
about people being too fine.
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44. - He's faking it.
- Good.
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45. The brain releases serotonin
when you smile,
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46. even if you're miserable.
I feel better already.
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47. Denial is not a proven strategy
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48. for psychological health.
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49. Dwelling on things you can't
change doesn't help either.
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50. 24-year-old woman came into the ER
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51. complaining of abdominal pain
and headaches,
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52. and, surprise, she's pregnant.
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53. Apparently not a happy surprise.
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54. She wants an abortion.
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55. Well, what's wrong with her?
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56. I assume you haven't
recently learned the value of sharing,
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57. which means there's another reason
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58. you're unloading this
onto the surgical department.
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59. She has a congenital IgA deficiency
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60. and a history of severe infections.
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61. She'll need IV antibiotics
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62. and close post-surgical observation.
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63. I figured one of your newbies
may as well learn something.
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64. Lea's birthday is tomorrow.
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65. There are many cute frogs
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66. and many romantic songs.
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67. I can't decide.
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68. It is my first gift as her boyfriend.
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69. It needs to be… awesome.
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70. Well, then, maybe singing frogs,
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71. however cute, might be a mistake.
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72. Try something more personal or romantic.
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73. And find a resident
who hasn't done a suction D&C
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74. and teach them.
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75. Oh. No, n… no.
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76. I'll do it myself.
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77. I'm not going to teach anymore.
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78. I'm a good surgeon. I'll do surgery.
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79. Dr. Murphy, part of your job as a surgeon
is to teach.
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80. You can't opt out because it's difficult.
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81. I am opting out because I'm bad at it.
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82. Well, you can't opt out for any reason.
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83. But I may have given you
too much responsibility too soon,
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84. so I will supervise your supervision
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85. until you get the hang of it.
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86. Pick someone.
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87. Did you two lose something?
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88. Our patient.
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89. Rose Babcock.
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90. She's post-op from repair
of a distal radius fracture.
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91. 60s. White hair.
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92. Looks at you
like she's staring into your soul.
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93. Does she have a limp?
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94. No.
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95. Well, I think she does now.
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96. Uh, Ms. Babcock,
did you fall down again?
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97. Oh, no, I'm fine.
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98. But… But there's a poor man in room 318
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99. who's in a lot of pain.
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100. Let's get you back in bed.
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101. Ah.
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102. Yep.
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103. Apply a new Tegaderm,
not antibiotic ointment.
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104. They breathe.
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105. Don't make us handcuff you
to the bed, Rose.
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106. We charge extra for that.
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107. Dry the skin more so it'll stick.
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108. You're doing just fine, dear.
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109. Heart rate's spiking
in the 130s.
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110. BP 162 over 95.
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111. Are you feeling any pressure
in your chest?
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112. No, it's just anxiety.
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113. Not mine. It's one of yours.
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114. We're gonna pretend,
since it's happening in your chest,
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115. that it's yours.
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116. 20 milligrams IV labetalol.
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117. I'm fine.
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118. I'm an empath.
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119. I can feel what other people are feeling,
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120. and one of you is very stressed out.
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121. Olivia, stay where you are.
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122. And one milligram of Ativan.
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123. Keep away from me!
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124. No! Step back!
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125. Sir, you were in an accident.
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126. We're taking care of you.
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127. Stop. Stop it! Now!
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128. Get away from me!
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129. I need you to hold him down
while I administer Haldol.
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130. Sir, please just…
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131. I'm warning you.
This room is being cleared.
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132. No one
is gonna hurt you.
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133. Ben.
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134. Huh?
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135. You're having a flashback.
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136. You're not in Afghanistan.
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137. You're in the hospital.
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138. Look around.
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139. What do you see?
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140. Zoe?
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141. Yeah. Yeah, baby, it's me.
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142. Zoe, I… I couldn't sleep.
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143. I… I went for a run, and I…
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144. I heard an explosion.
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145. And I don't…
I don't know what happened after that.
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146. You were hit by a car.
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147. We had to do surgery,
but you're gonna be okay.
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148. - It's okay.
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149. Take him back to his room,
make sure he didn't open his wound.
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150. I'm sorry.
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151. Dr. Murphy?
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152. Rose is not your patient.
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153. She was teaching me about her gift.
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154. She says the basis of empathy
is curiosity,
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155. which I find curious because…
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156. I'm curious about the job
you're supposed to be doing.
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157. Who are you leading
through the D&C?
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158. None of them.
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159. The only one who hasn't done one
does not want to,
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160. so I will.
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161. Which resident?
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162. Wanting to is irrelevant. It's their job.
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163. Wanting to is irrelevant. It's your job.
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164. I'm a Christian.
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165. Performing an abortion
goes against my beliefs.
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166. Okay.
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167. You may encounter a situation one day
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168. where this procedure
could save a woman's life.
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169. Then I hope someone else can…
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170. And it's my job to make sure
you can perform all surgeries,
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171. including abortions.
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172. So where does that leave us?
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173. I'll do the surgery.
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174. I've only done one.
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175. I'm sure there's a lot I still can learn.
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176. Dr. Murphy, you have a new student.
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177. Get her started running
pre-surgery assessments.
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178. Thank you, Olivia.
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179. That's the kind of ambition I like to see.
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180. He did three tours.
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181. He came home after he was injured
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182. in some kind of explosion.
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183. I don't really know what happened.
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184. Some… He's tried to tell me about it
several times,
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185. but he just… He breaks down.
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186. When was he diagnosed with PTSD?
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187. Two years ago.
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188. But he hasn't been the same
since he got back.
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189. At first, he was moody, irritable.
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190. Little things would set him off.
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191. Then the insomnia started.
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192. His mind is just… It's never at rest.
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193. Nights are the worst, you know?
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194. He, um…
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195. He gets these terrible nightmares.
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196. Flashbacks.
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197. Just… We can't sleep
in the same room anymore.
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198. Make sure he stays off his feet.
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199. Would you like us
to arrange a psych consult?
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200. We've been down that road.
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201. Talk therapy, group therapy,
exposure therapy…
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202. endless medications.
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203. Let us know if you change your mind.
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204. Jillian, I need those stats on elective
surgeries for my budget meeting.
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205. And a coffee.
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206. Jillian?
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207. She's not there. I need approval for this.
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208. And this.
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209. You said I couldn't give her the frogs.
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210. Oh, you can't give her this either.
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211. You don't know what it is.
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212. I know it would mean more if you had to
leave the building to get it.
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213. I would like to do
the suction D&C surgery.
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214. I assume your religious convictions
haven't changed in the last few hours.
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215. No.
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216. But I believe I was
put in this program for a reason.
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217. So, if you think it's important for me
to learn how to do an abortion,
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218. then I should learn.
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219. Take Jordan to the skills lab.
Run the surgery steps.
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220. You two will handle the D&C yourselves.
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221. With you.
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222. How are you going to supervise
my supervision
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223. if you're not there?
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224. I will help you prep
and debrief afterwards.
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225. But this patient doesn't need
a gallery of strangers
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226. standing around, gawking
at her most private experience.
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227. Sorry to interrupt.
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228. Ben woke up complaining of pain.
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229. Did you check the incision?
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230. The pain is in his arm.
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231. Now test external rotation
of the shoulder.
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232. - We're almost done.
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233. Can you describe the pain?
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234. Aah!
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235. We'll call it a 10.
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236. It's been hurting for years,
but, aah, this is…
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237. This is something else.
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238. How did you injure your shoulder before?
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239. I was in a…
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240. I was in a convoy in Kandahar,
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241. and there was a…
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242. I dislocated my…
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243. You don't need to discuss it with us.
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244. What did you find?
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245. Swelling, sensitivity to touch,
discoloration.
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246. - Could be CRPS.
- What is that?
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247. Well, it appears the car accident
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248. aggravated a prior injury.
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249. You've developed
complex regional pain syndrome.
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250. We'll start you
on Gabapentin and Dilaudid.
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251. Opioids make me a little insane.
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252. We could do a stellate ganglion block.
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253. It's an injection of anesthetic
near the spine
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254. that blocks the pain signals,
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255. and could also help the PTSD.
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256. I've been treated for PTSD for years.
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257. Why haven't I heard about this?
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258. It's experimental, but promising.
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259. The procedure comes with risks:
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260. vascular injury, infection,
major hematoma.
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261. Dr. Lim, I've been taking a risk
every time I go to sleep.
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262. I want to do it.
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263. Stellate block is an accepted procedure
for treatment of pain.
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264. Which you wouldn't have suggested
if the patient didn't
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265. also have a mental health condition.
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266. - I hear Jordan's back on the D&C,
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267. - in spite of her righteous indignation.
- Is something chirping?
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268. I think you're being unfair.
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269. Well, if anyone's being unfair, it's me.
I told Jordan to do it.
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270. I told her.
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271. We make decisions that
are hard to live with all the time.
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272. We make them anyway.
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273. And I told her pissing off the Chief
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274. was a very bad way
to start your residency.
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275. Glad you're still moonlighting
as surgical department camp counselor,
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276. but I don't mean
you were being unfair to Jordan.
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277. You're being unfair to the patient.
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278. She's facing
an emotionally fraught procedure.
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279. She needs the support of her doctors.
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280. And who she's getting is a rookie
who thinks she's committing murder.
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281. And Shaun.
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282. I have a point.
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283. I'll lead Jordan through the D&C myself.
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284. You're happy.
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285. Dr. Murphy will be happy.
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286. My cup runneth over.
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287. Now get whatever's in that box
out of my department.
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288. Morning sickness.
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289. Nurse Ella's.
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290. Rose claims she can feel her pregnancy.
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291. She was right about the guy in Room 318.
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292. He had a clot in his ankle.
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293. I'm sure she picked up
on some subtle clues,
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294. like the guy moaning
and grasping his ankle.
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295. Get a CT to rule out
abdominal injury from her fall.
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296. We're going to
insert a thin needle into your neck
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297. so we can inject the anesthetic.
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298. It may sting a bit.
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299. Use an in-plane approach
to place the needle
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300. between the C6 tubercle
and carotid artery.
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301. You might feel some discomfort.
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302. What's wrong?
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303. Zoe's hurt.
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304. I'm okay.
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305. Get some ice.
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306. Let me take a look.
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307. What happened?
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308. - I hit her.
- I was laying next to him.
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309. I know I shouldn't,
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310. but the shot just made his pain
feel so much better.
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311. - I thought…
- Zo.
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312. You didn't do anything wrong.
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313. There was a noise in the hall.
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314. - I lashed out.
- I know.
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315. I didn't mean to.
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316. I'm sorry.
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317. Nothing's broken.
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318. I can get you something for the swelling.
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319. No. I'm okay.
I'm gonna go home, get cleaned up.
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320. I just need some time.
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321. I love you.
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322. I think we can help Ben.
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323. There have been some promising results
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324. using Vagal Nerve Stimulation
to treat PTSD.
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325. His scarring
would make it impossible
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326. to expose and find the nerve
without damaging it.
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327. Those scars
are the reason that we need to try.
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328. Imagine reliving
your worst nightmare over and over again.
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329. Why doesn't anyone here
want to do the job they were hired for?
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330. What Ben needs is psychological help.
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331. I've ordered a consult.
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332. Leave it to the people
who are trained to do it.
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333. It sets a bad precedent
to force a resident
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334. to do a procedure
they're not comfortable with.
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335. Does anyone around here
not have an opinion
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336. about who should do
that damn abortion?
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337. Jordan had a choice,
and in my opinion, she made the right one.
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338. It's not a true choice
if you're coerced by your boss.
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339. I asked her to do her job.
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340. You took an opportunity
from a resident who wants to learn
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341. in favor of one who doesn't.
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342. Is this song and dance
about Jordan doing the procedure
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343. or your niece not doing it?
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344. Neither.
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345. There's a misconception that Olivia
came to St. Bonaventure because of me.
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346. She's here because of your reputation.
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347. The great Dr. Lim,
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348. a master class in technique,
professionalism, empathy.
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349. Lately, it doesn't seem like
that reputation holds up.
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350. I'm giving you
an antibiotic to prevent infection.
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351. The vacuum aspiration
will take about 15 minutes,
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352. and you'll be numbed
with a local anesthetic.
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353. Conscious sedation is also an option,
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354. but you will need someone
to drive you home afterwards.
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355. Do you have any questions for me?
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356. I'm scared.
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357. Are you certain you wanna
go ahead with the abortion?
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358. Yes.
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359. Then you don't have to be scared.
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360. You're the making
the right decision for you.
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361. Give her another 400 micrograms
of misoprostol.
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362. I'll be back for the procedure.
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363. This doesn't work.
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364. I need these numbers
in spreadsheet format.
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365. - Thank you.
- Oh, excuse me.
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366. Dr. Park?
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367. Rose's CT was normal.
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368. Get an upper GI barium study.
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369. First quarter supply costs you requested.
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370. Also, one of your first-years seems upset.
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371. He's been in the stairwell for a while.
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372. Everything okay in here?
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373. I just needed some quiet.
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374. Surgeons come into the stairwell
for two reasons,
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375. fire drills or doctor trauma.
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376. You having a fire drill?
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377. I just wish we had a more
effective treatment for Ben.
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378. His head's so messed up,
and we can't help him.
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379. I don't think this is about Ben.
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380. Have you ever lost a patient
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381. you knew you could have saved?
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382. When COVID was at its worst,
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383. we had to cancel
all non-urgent procedures.
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384. A young mom with a heart condition was
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385. more urgent than I thought.
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386. And she died waiting
for me to put her on the schedule.
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387. How do you get past that?
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388. You get past it because that's the job.
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389. You will always remember it.
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390. And you will eventually stop reliving it.
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391. How can you be so sure?
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392. Because if you don't,
you can't be a surgeon.
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393. And I'm pretty sure you're a surgeon.
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394. I should get back to work.
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395. Insert the speculum.
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396. Now dilate the cervix.
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397. Begin suction.
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398. Begin gentle suction in the uterus.
Copy !req
399. Is anything wrong?
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400. You're okay.
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401. Dr. Allen, I can take it from here.
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402. Don't worry. We're almost done.
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403. You're gonna be just fine.
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404. You have no idea
what that woman was going through,
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405. - and you made it worse for her.
- I know. I didn't…
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406. You had an opportunity to opt out
before you walked in there,
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407. but you agreed to do
the procedure,
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408. you took on an obligation to that patient,
and you failed her.
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409. If you ever do anything like that again,
I will have you removed from my program.
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410. Maybe you should be
cleaning bedpans for a while.
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411. Hopefully there's no moral objection
to that.
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412. Why are there adult toys on my desk?
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413. I've heard good things about the Llama,
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414. but online reviews aren't always accurate.
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415. Do you have a favorite?
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416. They're for Lea.
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417. Which one do you like the most, Claire?
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418. Uh…
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419. Uh…
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420. Evidence suggests that trauma
changes the way the brain works.
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421. An overactive amygdala
can heighten someone's response
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422. to emotional stimuli, including fear.
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423. I think we should consider
amygdala ablation for Ben.
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424. That's crazy.
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425. And completely outside
the scope of our care.
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426. - We're s…
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427. Oh.
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428. We're surgeons.
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429. We fix physiological problems,
not mental ones.
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430. It is a physiological problem.
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431. His brain isn't functioning properly.
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432. If it was a tumor
that was causing these reactions,
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433. you wouldn't hesitate to remove it.
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434. But there is no tumor.
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435. You're talking about
inflicting damage on his brain.
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436. He could suffer a stroke
or come out in a coma
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437. or not come out at all.
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438. If you use
a stereotactic laser approach
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439. rather than an open craniotomy,
you would greatly reduce the risks.
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440. This is not your case!
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441. You cannot jump into this one
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442. because you don't want to do
the one assigned to you,
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443. which is to teach,
which you've made my problem
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444. just like you made
Lea's birthday gifts my problem.
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445. You need to grow up
and accept some responsibility.
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446. I was diagnosed with PTSD last year.
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447. I kept it mainly private.
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448. Melendez really helped me through it.
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449. It was nice to have a friend to lean on.
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450. So if you need one…
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451. I feel
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452. off.
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453. Disconnected.
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454. Like I can't catch my breath.
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455. But
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456. it comes with the job.
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457. I'll get over it.
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458. It's Ben.
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459. Ben.
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460. No one is gonna hurt you.
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461. You're having a flashback.
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462. I know where I am.
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463. Every day since I came home,
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464. I've felt like
there's a monster chasing me.
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465. I try to outrun it
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466. but I end up hurting
the one I love the most.
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467. I'm a threat to everyone around me.
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468. No, Ben, you just need help.
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469. Nothing helps.
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470. I can't smile. I can't laugh.
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471. I can't feel anything but pain.
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472. I make everyone around me
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473. suffer.
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474. Ben.
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475. There's a surgery that may help.
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476. I would like to scrub in
on the amygdala ablation surgery.
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477. Rose said you're feeling overwhelmed
and need…
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478. I don't wanna hear any more things
that woman has said.
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479. Your job is to supervise your residents.
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480. Why are you here instead of doing that?
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481. You said you were
going to supervise my supervision,
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482. but you didn't.
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483. You took over my case.
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484. I don't know what I was
supposed to learn or how.
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485. Scrub in.
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486. Dr. Murphy,
walk Asher through the probe placement
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487. and trajectory to the amygdala.
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488. I will supervise your supervision.
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489. Okay, insert the probe
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490. perpendicular to the cortical surface.
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491. Stop! You're off course.
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492. On the current trajectory,
you will penetrate
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493. a branch of the choroidal artery
and cause a hemorrhage.
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494. - Step away from the probe.
- Your job is to teach,
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495. not take over.
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496. Adjust the probe
one millimeter inferiorly.
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497. Avoid the temporal horn on your right.
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498. I can't see it on the image guidance.
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499. Tell Asher what you see.
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500. It should point toward
your six o'clock on the Y axis.
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501. You have to feel it.
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502. The…
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503. The tissue plane
along the parenchyma is smooth.
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504. It should feel like gliding.
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505. You've reached the amygdala.
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506. Ready to begin
thermal laser ablation.
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507. Rose's upper GI and labs were normal.
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508. Should we keep her
another day to observe?
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509. No. If she's stable,
let's send her home.
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510. - Okay, I'll have Olivia…
- Open your mouth.
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511. Pardon me?
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512. Open your mouth.
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513. - I can, uh…
- Shut your mouth.
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514. - There's this rat.
- A mouse.
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515. A little dead mouse in the garage,
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516. and the big, strong man
is afraid to get it out.
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517. Not afraid, disgusted.
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518. Neither of us wanna deal with it,
Copy !req
519. so we are settling it
in the only responsible way, a bet.
Copy !req
520. A dare. A series of dares, actually.
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521. Whoever wusses out first has to…
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522. Take those things out of your mouth.
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523. I will discharge Rose.
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524. You two, go home.
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525. - We were just…
- Being idiots at work,
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526. while people are sick and dying.
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527. Go home.
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528. All your tests are normal.
We're discharging you.
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529. Right, because you're psychic.
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530. I'm an empath, not a psychic.
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531. Whatever the case,
I would suggest you take it easy.
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532. No drinking, no heavy lifting…
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533. You have to let it out, dear.
Copy !req
534. It was you.
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535. You made my heart rate spike.
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536. You're about to implode.
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537. There's nothing wrong with you… or me.
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538. Code blue!
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539. Yeah?
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540. Dr. Lim, my behavior yesterday
was inexcusable
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541. and unprofessional.
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542. I let you down. I let the patient down.
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543. I am deeply sorry.
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544. And I promise it will not happen again.
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545. You let your personal judgment
get in the way of doing your job.
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546. You're right. That is inexcusable.
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547. You said I had no idea
what the patient was going through.
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548. The truth is I kinda do.
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549. Scared, alone,
afraid of anyone finding out.
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550. I chose my career over motherhood,
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551. over my faith.
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552. But I don't regret it.
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553. And I know God forgave me
because I get to be here,
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554. living my dream of being a doctor.
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555. But I purposely try not to think about it.
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556. You're off scut duty.
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557. That's not why I…
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558. Take it.
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559. My name is Benjamin Alan Harris.
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560. I'm in St. Bonaventure Hospital
in San Jose.
Copy !req
561. Language and memory appear to be intact,
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562. and your motor function is normal.
Copy !req
563. But that doesn't mean it worked, does it?
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564. No.
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565. We'll have to do an fMRI
to see how you respond
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566. to fear-inducing stimuli.
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567. But we'll let you rest for now.
Copy !req
568. I'm not gonna rest
until I know I'm better.
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569. I want you to know
how I got these scars.
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570. No. Not now.
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571. Just give yourself time.
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572. I was in a convoy in Kandahar.
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573. I was in a Husky,
the big vehicle at the front.
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574. Ben, you don't have to do this.
Copy !req
575. Ronnie was driving.
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576. He was telling me a story,
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577. something about a goat at the base,
Copy !req
578. or maybe it was a chicken.
I don't know. But…
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579. We were laughing.
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580. Then the world was on fire.
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581. It's the Husky's job
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582. to spot IEDs.
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583. And I missed one.
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584. I can't see their faces.
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585. Just
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586. bodies everywhere.
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587. Dying alone,
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588. without their families.
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589. All I could do was hold their hand.
Copy !req
590. Are you okay, Ben?
Copy !req
591. Fun day.
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592. What do you need?
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593. We have a diagnosis.
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594. I thought I felt someone here.
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595. You've had a long day.
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596. You have Prinzmetal's Angina, Rose.
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597. A heart condition.
But it's very treatable.
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598. It explains all your symptoms,
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599. and it's exacerbated by stress,
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600. which is likely
what caused your heart attack.
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601. You need to stop seeking out
other people's pain.
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602. It's literally killing you.
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603. You're the Chief of Surgery.
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604. You could have sent somebody else
to tell me this.
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605. Sure.
Copy !req
606. But then I'd miss my chance to gloat.
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607. You're here because you're hurting
Copy !req
608. and you don't know where else to go.
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609. Go ahead. Use your magic.
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610. Tell me what's wrong with me.
Copy !req
611. How do I stop feeling like this?
Copy !req
612. It doesn't work that way.
Copy !req
613. I don't have a magic wand.
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614. I can only hold up a mirror,
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615. make you slow down,
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616. look at the parts of yourself
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617. that you've been trying to ignore
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618. because you're afraid
if you look too closely, you'll break.
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619. Maybe you will. I don't know.
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620. Maybe breaking is the point.
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621. You can't outrun your pain, Dr. Lim.
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622. If you keep trying, it's gonna kill you.
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623. Time of death,34.
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624. Time of death,13.
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625. Time of death,25.
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626. Time of death, 2100 hours.
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627. - Time of death…
- Time of death,26.
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628. - Time of death…
- Time of death,13.
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629. - Time of death…
- 26.
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630. - 55.
- Time of death…
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